Healthcare Provider Details

I. General information

NPI: 1336237833
Provider Name (Legal Business Name): KAREN L. GRAVES PMHNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 E 3RD ST STE 104
CASPER WY
82601-3200
US

IV. Provider business mailing address

301 THELMA DR # 226
CASPER WY
82609-2325
US

V. Phone/Fax

Practice location:
  • Phone: 307-462-4876
  • Fax: 307-337-3492
Mailing address:
  • Phone: 307-462-4876
  • Fax: 307-337-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR853137
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number23786.0844
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number23786.0844
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: